Individual
DR. JANICE ALBERDIENA VANNIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
7807 15TH AVE, KENOSHA, WI 53143-5913
(262) 656-1531
(262) 654-2031
Mailing address
7807 15TH AVE, KENOSHA, WI 53143-5913
(262) 656-1531
(262) 654-2031
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1777-057
WI
103TC0700X
Clinical Psychologist
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3568
CPQ-ASPPB
WI
01
—
42444
NATIONAL REGISTER
WI
Enumeration date
05/31/2007
Last updated
07/08/2007
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